Randy Bland

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

License

10126301 Issued in AZ

Practice address

14047 W Monte Vista Rd
Goodyear, AZ 85395

Phone

(480) 334-2092

NPI assigned

Dec 6, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Giving Grace Homes LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Buckeye, AZ
  • NPI 1598551061
  NPD Authorized official
• Reaching Beyond LLC

  • Assisted Living Facility (Behavioral Disturbances)
  • Chandler, AZ
  • NPI 1548057896
  NPD Authorized official
• Reaching Beyond LLC

  • Assisted Living Facility (Mental Illness)
  • Tucson, AZ
  • NPI 1710612817
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1700423902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC.",
            "address_2": "PO BOX 86537",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857546537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14047 W MONTE VISTA RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85395",
            "telephone_number": "480-334-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND",
        "first_name": "RANDY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-06",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "10126301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPEUTIC FOSTER CARE",
            "identifier": "1700423902",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "10126301",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Arizona, LLC
• Bio-Medical Applications of Arizona, LLC
• Biomechanix Physical Therapy, PLC
• Bismark Lake LLC
• Casey Marie Blaesing, OTR/L
• Randall J Blazic, DDS MD
• Blessing Care
• Alexander Bocchi, DPT
• Bodyworx Health Studio LLC
• Carolyn Marie Boehmer

• All providers in Goodyear, AZ
• Child Mental Illness Respite Care in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.